Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc Pharmacology

Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc

About Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Mechanism of Action of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Pharmacokinets of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Onset of Action for Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Duration of Action for Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Half Life of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Side Effects of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Contra-indications of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Special Precautions while taking Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Pregnancy Related Information
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Old Age Related Information
N/A
Breast Feeding Related Information
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Children Related Information
N/A
Indications for Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Interactions for Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Typical Dosage for Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Schedule of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Storage Requirements for Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Effects of Missed Dosage of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Effects of Overdose of Iron (Carbonyl Iron) + Vit B6 + Folic acid + Vitamin C + Zinc
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Iron (Carbonyl Iron)

About Iron (Carbonyl Iron)
A highly pure, nontoxic Iron(a minimum 98% iron content), Iron dietary supplement and to treat iron deficiency.
Mechanism of Action of Iron (Carbonyl Iron)
Iron formulations exerts haematinic action by being an essential constituent of haemoglobin. It is necessary for the oxidative process of living tissues.
Pharmacokinets of Iron (Carbonyl Iron)
Absorption: Absorbed orally in ferrous form and poorly absorbed in healthy individuals (about 10%) but in patients suffering from iron deficiency anaemia up to 60% dose is absorbed.
Distribution: Transported in a transferrin bound form in to bone marrow for incorporation in to haemoglobin.
Metabolism: Iron liberated by destruction of haemoglobin is reused by the body.
Excretion: Excretion of iron is minimal. Loss usually occurs in nails, faeces, urine, hair, sweat, and bile.
Onset of Action for Iron (Carbonyl Iron)
4 days
Duration of Action for Iron (Carbonyl Iron)
2 to 4 months
Half Life of Iron (Carbonyl Iron)
N/A
Side Effects of Iron (Carbonyl Iron)
1. Nausea
2. Epigasttric distress
3. Vomiting
4. Constipation
5. Diarrhoea
6. Black stools
7. Temporary staining of teeth with liquid formulations
Contra-indications of Iron (Carbonyl Iron)
1. Haemolytic anaemia unless iron deficiency anaemia is also present
2. Haemochromatosis
3. Haemosiderosis
4. Peptic ulcer
5. Regional enteritis
6. Ulcerative colitis
7. Those receiving repeated blood transfusions
Special Precautions while taking Iron (Carbonyl Iron)
1. Prolonged use
2. Minimise gastrointestinal discomfort by taking along with meals and gradually increasing the recommended dosage
3. Discontinue if intolerance occurs
4. Higher doses are required for geriatric patients
Pregnancy Related Information
May be used
Old Age Related Information
Use with caution
Breast Feeding Related Information
May be used
Children Related Information
Use with caution
Indications for Iron (Carbonyl Iron)
1. Iron deficiency
2. Iron deficiency during pregnancy and lactation
3. Iron deficiency in infants and children
Interactions for Iron (Carbonyl Iron)
(Oral Iron): Antacids: GI absorption of iron reduced.
Ascorbic acid: GI absorption of iron enhanced.
Chloramphenicol: Serum iron levels may be increased.
Cimetidine: GI absorption may be reduced.
Levodopa: Decreased levodopa serum levels.
Methyldopa: May result in decreased efficacy of methyldopa.
Quinolones: GI absorption of quinolones decreased.
Penicillamine: Marked reduction in GI absorption of penicillamine.
Tetracyclines: Decrease in the absorption of both tetracyclines and iron salts.
Food: Eggs and milk inhibit iron absorption. Administration of calcium and iron supplementation with food reduces ferrous sulfate absorption by one-third. If combined iron and calcium supplementation required then calcium carbonate should be used and the supplementation taken between meals.
Typical Dosage for Iron (Carbonyl Iron)
Oral:
Ferrous fumarate:
Adults: Starts with 50 to 100mg 2 to 3 times daily. Adjust the dosage based on patient`s response.
Children: 4 to 6mg/kg daily in three divided doses.
Ferrous sulphate:
Adults: 100 to 300mg; twice daily. Increases the dosage based on patient`s response if required up to 300mg 4 times daily.
Children (age 2 to 12): 3mg/kg/day in three to four divided doses
Children (age 6months to 2years): 3 to 6mg/kg/day in three to four divided doses
Infants: 10 to 25mg/day in three to four divided doses.
Ferrous gluconate:
300 to 1200mg daily in three to four divided doses.
Children (age 2 to 12): 3mg/kg/day in three to four divided doses
Children (age 6months to 2years): 3 to 6mg/kg/day in three to four divided doses
Infants: 10 to 25mg/day in three to four divided doses.
Schedule of Iron (Carbonyl Iron)
H
Storage Requirements for Iron (Carbonyl Iron)
Store in a well closed container in a cool dry place. Protect from light.
Effects of Missed Dosage of Iron (Carbonyl Iron)
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Iron (Carbonyl Iron)
Treatment includes immediate support of airway, respiration, and circulation. In conscious patients induce emesis with ipecac; if not empty stomach by gastric lavage. Follow emesis with lavage, using a 1% sodium bicarbonate solution to convert iron to less irritating poorly absorbed form. Take abdominal X-ray to determine presence of excess iron. Deferoxamine may be used for systemic chelation if serum levels of iron exceed 350mg/dl.

Vit B6

About Vit B6
Physiological functions: It is involved as a coenzyme (Pyridoxal phosphate) in metabolism of tryptophan, in several metabolic transformations of amino acids including transamination, decarboxylation & racemization.
Deficiency symptoms: Peripheral neuritis, seizures, stomatitis, glossitis, anaemia, seborrhea like lesions.
Mechanism of Action of Vit B6
Vitamin B6 is a collective term for Pyridoxine, Pyridoxal, Pyridoxamine and their phosphorylated derivatives such as Pyridoxine phosphate, Pyridoxal phosphate and Pyridoxamine derivatives respectively. Vitamin B6 is essential for the metabolism of amino acid, glycogen and fatty acids, for nerve functions, for the formation of red blood cells and also helps the skin healthy. Vitamin B6 is also used for the synthesis of nucleic acid, Haemoglobin, Sphingomyelin, other Sphingolipids, Serotonin, Dopamine, Noradrenaline and GABA.
Pharmacokinets of Vit B6
Absorption: Vitamin B6 is readily absorbed after oral administration.
Distribution: It is mainly distributed in the body in protein bound form. It is stored primarily in the liver and to a lesser extent muscle and brain.
Metabolism: It is metabolised in the liver
Onset of Action for Vit B6
N/A
Duration of Action for Vit B6
N/A
Half Life of Vit B6
15-20 days
Side Effects of Vit B6
1. Neuropathy
2. Unstable gait
3. Drowsiness
4. Perioral numbness
5. Paresthesia
6. Numbness of feet
7. Somnolence
8. Sensory neuropathy
9. Ataxia
Contra-indications of Vit B6
1. Hypersensitivity to Vitamin B6
Special Precautions while taking Vit B6
N/A
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
Use with caution
Children Related Information
Use with caution
NEONATES: Contraindicated
Indications for Vit B6
1. Vitamin B6 deficiency including inadequate diet and drug induced causes
2. Neuropathy
3. Premenstrual syndrome
4. Hyperoxaluria type 1
5. Metabolic disorder
6. Isoniazid poisoning
Interactions for Vit B6
Cycloserine, Hydralazine, Isoniazide, Oral contraceptive, Penicillamine: Increase Pyridoxine requirement.
Levodopa: Pyridoxine reverses the therapeutic effect of Levodopa.
Phenobarbital, Phenytoin: Pyridoxine decreases serum level of these anticonvulsants.
Typical Dosage for Vit B6
Adult: 10 - 20 mg / day
Dietary deficiency: 2.5 -10 mg / day for effective therapeutic response is obtained.
Maintenance dose: 2 - 5 mg / day for several weeks.
Drug induced deficiency: 100 - 200 mg / day for 3 weeks.
Maintenance dose: 25 - 100 mg / day
Neuropathy: 50 - 200 mg /day
Premenstrual syndrome: 40 - 500 mg / day
Hyperoxaluria type 1: 25 - 300 mg / day
Metabolic disorder: 100-500 mg /day.
Isoniazid poisoning: Initial dose: 1 - 4 g as IV administration, then 1 g IM every 30 minute until Pyridoxine dose is equal to the Isoniazid dose has been given.
Schedule of Vit B6
N/A
Storage Requirements for Vit B6
Store it at 15 - 30 degree C. Protect from moisture and heat.
Effects of Missed Dosage of Vit B6
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vit B6
Give supportive measures and symptomatic treatment. The signs of Pyridoxine overdose can be resolved by discontinuation (withdrawal) of Pyridoxine.

Folic Acid

About Folic Acid
Dietary supplement, Folate derivative( B9 ), Water Soluble Vitamin.
Mechanism of Action of Folic Acid
Folic acid reduced by enzymes folate reductase and dihydrofolate reductase and forms dihydrofolic acid tetrahydrofolic acid respectively. Tetrahydrofolic acid acts as a coenzyme which mediates a number of one carbon transfer reactions by carrying a methyl group as an adduct. It involves a number of reactions such as 1).conversion of homocysteine to methionine. 2).synthesis of thymidylate which is an essential constituent of DNA from methylene-tetrahydrofolic acid. 3). Conversion of serine to glycine by tetrahydrofolic acid and forms methylene-tetrahydrofolic acid. 4).to introduce carbon units at position 2 and 8 during de novo purine synthesis requires formyl-tetrahydrofolic acid and methenyl-tetrahydrofolic acid.5).generation and utilization of "formate pool". 6).For mediating formino group transfer in histidine metabolism. Folic acid is required to maintain normal erythropoiesis and nucleoprotein synthesis.
Pharmacokinets of Folic Acid
Absorption: Well absorbed orally
Distribution: Widely distributed in the body and highest concentration is seen in liver. It appears in the CSF and breast milk
Metabolism: Metabolized in to N-methyl tetrahydrofolic acid in liver
Excretion: Extra drug is excreted unchanged in urine. A small portion of folate is lost by a combination of urinary and fecal excretion and oxidative cleavage of molecule.
Onset of Action for Folic Acid
Oral: 20 to 30minutes
I.V.: 5 minutes
I.M.:10 to 20minutes
Duration of Action for Folic Acid
Oral: 3 to 6 hours
I.V.:3 to 6minutes
I.M.:3 to 6hours
Half Life of Folic Acid
N/A
Side Effects of Folic Acid
N/A
Contra-indications of Folic Acid
N/A
Special Precautions while taking Folic Acid
1. In patients with undiagnosed anaemia; because it may mask pernicious anaemia
2. In pernicious anaemia and other megaloblastic where vitamin B12 is deficient
Pregnancy Related Information
May be used
Old Age Related Information
May be used
Breast Feeding Related Information
May be used
Children Related Information
May be used
Indications for Folic Acid
1. Megaloblastic anaemia
2. Folic acid deficiency
3. Anaemias of pregnancy
4. Nutritional anaemia
5. Alcoholism
6. Tropical sprue
7. Non tropical sprue
Interactions for Folic Acid
1. Hypersensitivity reactions with injection form
2. Bronchospasm
Typical Dosage for Folic Acid
Oral: 5mg 1 to 4 times daily; depending up on the severity of deficiency.
Maintenance dosage: Half of the therapeutic dosage.
Children: 2.5 to 5mg 1 to 2 times daily.
Schedule of Folic Acid
C1 (Oral)
C (Parenteral)
Storage Requirements for Folic Acid
Store at controlled room temperature at a range of 15 to 25 degree C in a well closed container. Protect from excess heat, light and moisture.
Effects of Missed Dosage of Folic Acid
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Folic Acid
Relatively non toxic. Provide symptomatic treatment and supportive measures.

Vitamin C

About Vitamin C
Water soluble vitamin, antioxidant.
Mechanism of Action of Vitamin C
Vitamin C exerts it`s action by influencing the biologic oxidations and reductions used in cellular respirations. It directly stimulates collagen synthesis and maintains intracellular connective tissue. It involves in various metabolic reactions such as 1).Hydroxylation of praline and lysine residues of protocollagen which is essential for formation and stabilization of collagen triple helix, 2).hydroxylation of carnitine, 3).Conversion of folic acid to folinic acid, 4).biosynthesis of adrenal steroids, catecholamines, oxytocin, and ADH, 5).Metabolism of cyclic nucleotides and prostaglandins. Vitamin C is important in resistance to infections.
Pharmacokinets of Vitamin C
Absorption: Well absorbed orally.
Distribution: Widely distributed both extracellularly and intracellularly, It crosses the placenta and also distributed in to the breast milk.
Metabolism: Metabolized in the liver; partly oxidized in to active dehydroascorbic acid and inactive metabolites.
Excretion: Inactive metabolites and extra drug is excreted through urine.
Onset of Action for Vitamin C
N/A
Duration of Action for Vitamin C
N/A
Half Life of Vitamin C
N/A
Side Effects of Vitamin C
1. Discomfort at injection site
2. Acid urine
3. Renal calculi
4. Oxaluria
Contra-indications of Vitamin C
No known contraindications
Special Precautions while taking Vitamin C
1. Renal impairment
2. Ingestion of large doses during pregnancy has resulted in scurvy in neonates
Pregnancy Related Information
Use with caution
Old Age Related Information
Use with caution
Breast Feeding Related Information
Use with caution
Children Related Information
May be used
Indications for Vitamin C
1. Scurvy
2. Prophylaxis and treatment of vitamin C deficiency
3. As an antioxidant to maintain natural colour and flavour of food items
4. For acidification of urine
5. Capillary fragility
6. Dental caries

Interactions for Vitamin C
Oral contraceptives and estrogens: Vitamin C increases serum levels of oestrogen resulting in adverse reactions .
Warfarin: The anticoagulant effects of warfarin is reduced.
Lab Tests: Large doses (>500 mg) of vitamin C may cause false negative urine glucose determinations. May result in false negative amine dependent stool occult blood tests.
Typical Dosage for Vitamin C
Oral:
Adults: 50 to 1000mg/day depending up on the requirement.
Pregnancy and lactation: 100 to 150mg/day
Children: 30 to 100mg/day.
Scurvy:
Oral:
Adults: 1000mg twice daily to thrice daily.
Children: 300mg to 1000mg daily.
Sub clinical scurvy:
Oral, S.C., I.M., or I.V.: 100 to 250mg once daily or twice daily depending up on the severity of the condition. Then give a maintenance dosage of 50mg/day.
Children: 100 to 300mg depending up on the severity. Then give a maintenance dose of 35mg/day.

Schedule of Vitamin C
C1 (Oral)
C (Parenteral)
Storage Requirements for Vitamin C
Store in a cool dry area in a well closed container. Protects from moisture, light and direct heat.
Effects of Missed Dosage of Vitamin C
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Vitamin C
Discontinue the therapy and provide symptomatic and supportive measures.

Zinc

About Zinc
Trance metal, Dietary mineral, Nutritional supplement,Treatment of zinc deficiency,in wound healing.
Mechanism of Action of Zinc
Zinc acts as a cofactor for more than 70 different enzymes. Zinc dependent enzymes are involved in the metabolism of carbohydrates, lipids, and proteins. Zinc facilitates wound healing, normal growth rates, normal skin hydration and maintains senses of taste and smell. It provides normal growth and tissue repair. It also helps in development of cell mediated immunity.
Pharmacokinets of Zinc
Absorption: Poorly absorbed orally, Distribution: Zinc is distributed mainly in to skeletal muscle, skin, bone, pancreas, kidney, liver, retina, prostate, RBC, and WBC. Excretion: Excreted mainly through intestine; only 2% loss in the urine.
Onset of Action for Zinc
N/A
Duration of Action for Zinc
N/A
Half Life of Zinc
N/A
Side Effects of Zinc
1. Nausea
2. Vomiting
3. Abdominal distress
4. Gastric ulceration
5. Rashes
Contra-indications of Zinc
N/A
Special Precautions while taking Zinc
1.Don`t exceed prescribed dose
2.Renal failure
3.Biliary obstruction

Pregnancy Related Information
Use with caution
Old Age Related Information
N/A
Breast Feeding Related Information
N/A
Children Related Information
N/A
Indications for Zinc
1. Zinc deficiency
2. Acne vulgaris
3. Chronic skin ulcers
4. Adjunct to antimicrobials
5. Delayed wound healing
6. Alopecia
Interactions for Zinc
Fluoroquinolones, Tetracyclines: Decreased GI absorption and serum levels of some fluoroquinolone.
Pencillamine: Reduced absorption of zinc.
Iron: Reduced absorption of iron and vice versa.

Typical Dosage for Zinc
Adults: 25 to 50mg zinc daily or 1 to 2 tablets daily.
Children: 5mg/kg 1 to 3 times daily.
Schedule of Zinc
N/A
Storage Requirements for Zinc
Store at a temperature below 30 degree C
Effects of Missed Dosage of Zinc
Take the missed dose as soon as noticed and if it is the time for next dose then skip the missed dose. Continue the regular schedule. Do not double the dose.
Effects of Overdose of Zinc
Provide symptomatic treatment and supportive measures

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